What are the symptoms of thyroiditis?

Written by Li Hui Zhi
Endocrinology
Updated on September 04, 2024
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Subacute thyroiditis is commonly referred to, and it is frequently seen clinically with symptoms such as fever, pain in the neck, and mild hyperthyroidism symptoms in the early stages, such as palpitations, insomnia, weight loss, irritability, and increased frequency of bowel movements. Therefore, if you have these symptoms, it is important to promptly visit an endocrinology specialist to see if you are suffering from subacute thyroiditis. Diagnosis can be confirmed through blood tests, thyroid function tests, thyroid ultrasound, routine blood tests, and erythrocyte sedimentation rate tests.

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Symptoms of thyroiditis and hypothyroidism

Because the onset of hypothyroidism is gradual, its early symptoms are atypical. Specific symptoms only appear when there is a decrease in basal metabolic rate and a reduction in sympathetic nerve excitability. Generally, symptoms include cold intolerance, fatigue, swelling of hands and feet, drowsiness, memory decline, reduced sweating, joint pain, weight gain, constipation, and menstrual irregularities such as heavy or light periods, or infertility in women of childbearing age. Additionally, some common clinical signs include expressionless face, slow response, hoarse voice, hearing impairment, pale complexion, edema around the eyelids, face and lower limbs, thick tongue coating often with teeth marks. Moreover, there are also associated symptoms such as dry skin, flaky skin, low skin temperature, and the hands and feet turning a yellowish-orange color.

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Symptoms of hypothyroidism in thyroiditis

There are many types of thyroiditis, and the most common one associated with hypothyroidism is Hashimoto's thyroiditis. Symptoms of hypothyroidism include multi-system involvement. In the nervous system, it manifests as reduced memory and attention, and drowsiness; in the cardiovascular system, it presents as bradycardia, faint heart sounds, and cardiac enlargement; in the musculoskeletal system, it manifests as slowed movement and joint disorders; in the digestive system, it presents as loss of appetite, bloating, and constipation; in the respiratory system, it manifests as weak and shallow breathing; in the hematologic system, it can manifest as anemia; in the endocrine system, it can present as reduced gonadal function accompanied by hyperprolactinemia, menorrhagia, amenorrhea or infertility, hair loss, and the skin and mucous membranes appear pale with myxedema.

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Causes of Acute Thyroiditis

We generally refer to acute thyroiditis as an acute suppurative thyroiditis, which is a type of purulent infectious disease, often caused by a mixed bacterial infection, such as staphylococcus, streptococcus, gram-negative bacilli, and anaerobes, etc. Patients with compromised or deficient immune functions, such as those with AIDS, leukemia, diabetes, can also have infections like fungi and pneumocystis. Some thyroid nodules, due to events like necrosis or cystic changes from punctures, can also cause a suppurative infection, and this condition is generally common among middle-aged and elderly patients. Therefore, the main cause of acute thyroiditis is mostly due to infections.

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Endocrinology
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There are several types of thyroiditis.

Thyroiditis primarily includes acute, subacute, and chronic forms. Acute and subacute thyroiditis are generally seen in bacterial and viral infections, while chronic thyroiditis mainly consists of autoimmune thyroiditis, painless thyroiditis, and postpartum thyroiditis. However, autoimmune thyroiditis itself encompasses five scenarios, including Hashimoto's thyroiditis, atrophic thyroiditis, painless thyroiditis, euthyroid thyroiditis, and Hashitoxicosis. These types of thyroiditis are mainly seen in chronic thyroid conditions and are all autoimmune diseases. Therefore, the type of thyroiditis should be determined based on the cause to develop appropriate treatment plans.

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Where is the best place to perform moxibustion for thyroiditis?

Thyroiditis is relatively common in clinical practice, but we have not yet found that moxibustion directly helps with thyroiditis, so we do not recommend using moxibustion for treatment. Especially for types of thyroiditis that may cause an increase in thyroid hormone release, such as the acute phase of subacute thyroiditis. If moxibustion is applied directly near the thyroid region, it could potentially cause an increase in thyroid hormone release, exacerbating existing symptoms and hindering recovery. When we suffer from thyroiditis, we should choose appropriate treatment plans according to different types. For autoimmune thyroiditis, we can use treatments that regulate immunity, provide symptomatic relief, and supplement or replace hormone levels. Some painless thyroiditis may only require regular follow-ups. For cases of thyroiditis that also involve thyroid enlargement, treatment options like iodine-131 or surgery can be considered depending on the functional status.